Nasogastric tube (ryles tube intubation) by meghana c

THIS PPT DESCRIBES THE COMPLETE NOTE ON NG TUBE INTUBATION.
this ppt is particularly made for paramedical & allied health science students

1. NASOGASTRIC INTUBATION Meghana c DOTT, BOTT, II Year M.Sc Medical Biochemistry

2. CONTENTS DEFINITION PURPOSE INDICATION POSITION & EQUIPMENT PROCEDURE DETERMINNATION OF THAT TUBE IS IN STOMACH BY FOLLOWING METHODS ADVANTAGES COMPLICATIONS CONTRAINDICATIONS

3. DEFINITION It is the insertion of a tube into the oesophagus and stomach through the nose It is defined as the passage of single or double lumen tube through the nose or mouth to stomach for the purpose of the drainage, instillation, decompression, lavage or performance of diagnostic tests .

4. PURPOSE To feed the patient with fluids when oral intake is not possible To dilute and remove consumed poison To instill ice cold solution to control gastric bleeding To prevent stress on operated site by decompressing To relive vomiting and distension To collect gastric juice for diagnostic puposes

5. INDICATIONS Patient who cannot eat (GIT functioning normally) Comatose patient Mechanically ventilated Patient who will not eat Patients who refuse to eat Elderly • Disoriented patients Patients who cannot maintain adequate oral nutrition Patients with infection, trauma, cancer, Surgery etc.

6. POSITION & EQUIPMENT POSITION Fowler's position. EQUIPMENT Nasogastric tube, of specified size Clamp Water-soluble lubricant Glass of water or ice chips Tape Stethoscope

7. PROCEDURE Explain procedure to patient. Assemble equipment and examine tube for defects (rough edges or partially closed lumens) Position patient Instruct patient to blow nose to clear nostrils. Use a flashlight and occlude one nostril at a time to assess patency of nostrils before choosing site for insertion. Measure tube for placement from tip of nose to ear lobe to bottom of xiphoid process; mark tube with tape. Note location on tube; you may mark tube with tape or nontoxic marker.

8. PROCEDURE 6. Provide patient with glass of water or ice chips. 7. Lubricate tip of tube with water-soluble lubricant and begin insertion. 8. After it reaches the nasopharynx may help to prevent tube from entering patient's mouth. Instruct patient to take a swallow of water or suck on ice chips once tube passes nasopharynx. 9. Keep his/her chin tucked toward chest so that the tube passes into the stomach and not lungs. 10. Continue insertion in rhythm with swallowing until desired length of tube is passed.

9. DETERMINNATION OF THAT TUBE IS IN STOMACH BY FOLLOWING METHODS Place stethoscope over stomach, inject 10 mL of air into tube and listen for air passage.

10. DETERMINNATION OF THAT TUBE IS IN STOMACH BY FOLLOWING METHODS Gently aspirate stomach content with irrigating syringe. Fluid from stomach or small bowel may be:- Green, Tan, Brown, Clear, yellow, Bloody or Bile- colored .

11. Pulmonary fluid may be:- Tan off white, clear or pale yellow.

12. BY DETERMINING ASPIRED FLUID Ph from stomach is 1.0 to 6.5 from small intestine 7.5 to 8.0 from the lungs over 6.0 however, none of these is fail-safe. NOTE : If any doubt exists, placement should be checked with X-rays. It should be noted that chest X-ray is the only way to confirm correct placement.

13. ADVANTAGES An adequate amount of all types of nutrients including distasteful foods & medications can be supplied Large amount of fluids can given with safety It can be continued weeks with out any danger The stomach may be aspirated at any time of desired Overloading of the stomach can be prevented by drip method

14. THESE TUBES MAY ALSO BE ASSOCIATED WITH THE FOLLOWING COMPLICATIONS Rhinitis Pharyngitis Oesophageal ulceration Gastric erosion Increased tendency for reflux Patient discomfort Difficulty swallowing .

15. CONTRAINDICATION Gastric surgery Ulcers Tracheoesophageal fistula Oesophageal surgery Polyps in nose recent nasal surgery facial surgery Deviated nasal septum Patient on anticoagulant therapy Tracheotomy